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Newsletter Issue: 16 — Date: 4th October 2006 — Web Site: http://www.my-blood-pressure.com

Welcome to the My Blood Pressure newsletter!

In this issue, Dr Nicholas M Keegan has kindly submitted an article about the European VAT tax, and Colin Slater has shared his experience with blood pressure monitoring — a story that has a happy ending!

European Union VAT and software, specifically the My Blood Pressure program

Note: This article is only relevant to residents of the European Union.

By Dr Nicholas M Keegan, BA, PhD.

After running the trial version of My Blood Pressure and being completely satisfied with it I was about to purchase the full copy. However, I often buy goods from non-EU countries over the Internet and had never heard of EU VAT being added to the price. So, having a suspicious sort of nature, I checked up on this first. As I’m a UK resident, I checked with the relevant government department, HM Revenue and Customs. Their website is at http://www.hmrc.gov.uk. If you follow the VAT links on this you will come to a series of information sheets. It is a very complicated and tortuous subject so I have extracted and edited the following information from VAT Info Sheet 04/03. The changes came into force in 2003.

“This Information Sheet sets out guidance on, and gives examples of what is meant by ‘electronically supplied services’. It will help businesses decide whether their supplies will be affected by changes to the place of supply rules for such services, following implementation of the VAT on E-Commerce Directive (2002/38/EC) which take effect from 1 July 2003.

Who is affected by these changes?

  • UK businesses supplying electronically supplied services;
  • non-EU businesses supplying electronically supplied services to EU customers; and
  • UK businesses and non-business organisations receiving electronically supplied services from outside the UK.

What is an ‘electronically supplied service’? An ‘electronically supplied service’ is one that:

  • in the first instance is delivered over the Internet or an electronic network (i.e. reliant on the Internet or similar network for its provision); and then
  • the nature of the service in question is heavily dependent on information technology for its supply (i.e. the service is essentially automated, involving minimal human intervention and in the absence of information technology does not have viability).

Therefore, on the basis of this two step test, an ‘electronically supplied service’ includes:

  • digitised products generally, such as software and changes to or upgrades of software; or
  • a service which provides, or supports a business or personal presence on an electronic network (e.g., web site or web page); or
  • a service automatically generated from a computer, via the Internet or an electronic network, in response to specific data input by the customer; or
  • services, other than those specifically mentioned in Annex L, which are automated and dependent on the Internet or an electronic network for their provision.

In all instances, electronically supplied services will be taxable at the standard rate established by a Member State (in accordance with Article 12(3)(a) of the Sixth Directive), unless an exempting provision in a Member State applies.”

All is above board, therefore, and I went ahead and bought the full version of My Blood Pressure. And in case anyone is still suspicious, the e-commerce company handling the administration of collecting and remitting the VAT, although not based in the UK, has complied with the EU regulations and has an EU registration number, EU826005198. I hate paying tax (17.5% VAT in the UK) as much as the next person, but this regulation is one of the many that have been imposed by Brussels in all 25 EU Member States.

By Dr Nicholas M Keegan, BA, PhD

Blood Pressure News Roundup

A great mix of new research was released this month which shows exercise, alcohol, sleep and work all affect blood pressure levels, and are best kept in moderation.

An important study has revealed reducing blood pressure levels in people with coronary heart disease can stop or even reverse coronary heart disease. Patients with coronary heart disease whose blood pressure levels were 120/80 or less actually had a reduction of plaque in the arteries over a 2 year period.

Also positive news for those planning on quitting smoking, research shows that it’s never too late too quit to improve heart health.

Enjoy the news!
Thanks Kellie

Insomnia linked to high blood pressure
Several new studies released in the Archives of Internal Medicine have linked insomnia and poor sleep to health problems such as; high blood pressure, Type 2 diabetes, heart failure and depression. Researchers are recommending physicians include sleep habits as part of a regular and complete patient check-up. Sleep problems shouldn’t be ignored and can be treated they claim. The studies suggest that the immune system may be weakened by lack of sleep which makes people more susceptible to inflammation and disease. (Full story)

Excess weight on the waist increases blood pressure
A 10 year study has shown people who carry their excess weight around the middle are at higher risk of high blood pressure. The findings released in the American Journal of Hypertension showed those with an ‘apple’ shaped figure were at higher risk for heart disease and Type 2 diabetes. The researchers studied a group of 2,377 people over 30 years to find that as the waistline increases so does blood pressure. (Full story)

Women in their 60’s at risk for heart disease
In previous decades older men had greater chance of heart disease than older women. A new study has shown this is no longer true today. In a study of 900 women over the age of 60 years, higher rates of diastolic and systolic blood pressure were shown compared to men of the same age. The research also showed that blood pressure medication had reduced effectiveness on women compared to men. Lead researcher Professor Crimmins from the University of Southern California said, “Women are no longer protected from heart disease relative to men.” (Full story)

A few walks daily helps blood pressure
Indiana University researchers claim 3 or 4 short walks daily are more beneficial in lowering blood pressure than 1 longer session of exercise. Researcher Professor Janet Wallace stated, “Four 10 minute walks would be ideal”. The study, published in Hypertension showed any exercise is beneficial for hypertension sufferers. However, those who took 4, 10 minute brisk walks daily found their blood pressure was reduced for a longer period throughout the day. (Full story)

Heart disease risk found in teenagers
A new study published in Hypertension shows that insulin resistance in teenagers may help to predict the likelihood of developing heart disease latter in life. Researchers studied 357 students in Minneapolis schools to discover children who showed signs of insulin resistance at aged 13 faced a higher risk of heart disease by age 19. Lead researcher Alan Sinaiko, M.D. stated, “This is the first study to show insulin resistance by itself is a significant predictor of cardiovascular disease, beginning in childhood.” The findings will help to determine those children who are at increased risk of heart disease and Type 2 diabetes in adulthood. (Full story)

Working long hours a risk factor for hypertension
Researchers at the University of California have confirmed that working long hours increases the risk of high blood pressure, especially if the person has little control over the job. The study reported in Hypertension: Journal of The American Heart Association studied over 55,000 households to determine the link between high blood pressure and working hours. Workers with minimal control over their jobs for example; clerical or unskilled workers were at highest risk, indicating that job satisfaction is important. Researchers recommend that Doctors include work hours as a risk factor for hypertension when assessing patients. (Full story)

Tobacco increases heart attack risk
A Canadian-led global study of 52 countries and over 27,000 people has found exposure to any form of tobacco increases the risk of heart attack. Researchers from McMaster University found any form of tobacco use, including chewing, sniffing or inhaling was harmful. Smokers had a three fold increased risk of heart attack compared to those who had never smoked. However, researchers found that the risk of heart attack reduced over time once smoking stopped. For example, light smokers on 10 or less cigarettes a day had no excess risk of heart attack 3 to 5 years after stopping. Dr. Peter Kiu from the Institute of Circulatory and Respiratory Health (CIHR) said “People around the world should pay attention to the message that it’s never too late to quit”. (Full story)

Exercise is fine for high blood pressure
A new study from Johns Hopkins University shows that moderate exercise and the short term effect of an increase in blood pressure as a result of the exercise does not harm the heart. A group of 104 adults with mild, untreated hypertension with an average age of 63 years underwent a moderate exercise program for 6 months. The benefits of exercise are well documented; however there had been concern that the immediate spike in blood pressure that follows may harm the heart. The research published in Heart showed no negative effects. Those who exercised increased their oxygen intake and lost abdominal fat. Researchers suggest most people with mild hypertension can benefit from regular exercise, once they have the all clear from their physician first. (Full story)

Stop or reverse heart disease by controlling blood pressure
A new study reported in the Journal of the American College of Cardiology shows reducing blood pressure of people with coronary artery disease may stop or even reverse the disease. Cleveland Clinic researchers studied 274 patients over a 2 year period. They found patients with blood pressure levels 140/90 or over showed a significant increase in plaque in their arteries over the 2 years. Patients with levels 120/80 to 139/89 showed no change in amount of plaque. However, patients whose blood pressure levels were 120/80 or less showed a reduction of plaque in the arteries over the 2 year period. (Full story)

Walking ability in the aged affected by hypertension
An 8 year long study of 888 elderly people has shown high blood pressure can impair walking ability in older age. Researchers at the Rush University Medical Center found lower limb function decreased 28.7% faster in persons with a systolic blood pressure of 160mmHg compared to those with a normal systolic blood pressure of 120mmHg. The annual evaluation tested gait and balance by performance based tasks, such as climbing stairs. Researchers highlight the importance of monitoring and controlling blood pressure to assist with maintaining healthy lower limb function. (Full story)

Contributed by: Kellie

My Story

This section contains stories and articles contributed by our users and subscribers. If you have something to contribute, we would love to hear from you. Email Kellie or Steve at support@my-health-software.com with your idea or story!

My Story – Colin Slater

Moved to: People who Monitor their Blood Pressure

About us

This newsletter is put together by a brother and sister team.

Steven Alan is 37 and is the programmer of the My Blood Pressure software. Steve was diagnosed with high blood pressure in February 2004. Steve needs to monitor his blood pressure regularly, and will probably need to do so for the rest of his life. Steve’s systolic blood pressure was over 200 at one point, but recently he has got his blood pressure under control, and most readings are below 120/80.

Steve is responsible for contributing news about the software as well as tips and tricks for using the software.

Kellie Helen (Steve’s sister) is 35 and a full time mother to a 5 (Steves Note: my neice tells me she is not 5, but “nearly 6″!) and 4 year old. In her spare time!, she has started working with Steve on the website and newsletter. Kellie grew up in a household which had its fair share of blood pressure problems! Their father has always had high blood pressure, but somehow Steve got all the high blood pressure genes, while in her teens, Kellie used to suffer from her blood pressure being too low. Kellie worked in the medical and surgical industry before becoming a full time mum, and is looking forward to spending more time on this project as her children get older.

Kellie is responsible for scouring the net for news stories of interest to people who monitor their blood pressure, and collecting and organizing stories contributed by subscribers.

My Health Software
PO Box 1468
Rozelle 2039
Australia
Kellie: kellie@my-blood-pressure.com
Steve: steve@my-blood-pressure.com

Disclaimer: Nothing contained in this newsletter is intended to be instructional for medical diagnosis or treatment. It should not be used in place of the advice of your health care provider.

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